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Description

Community HealthChoices (CHC) is Pennsylvania's managed care long term services and supports (LTSS) program serving seniors and individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid.

Performs analysis of data and information for various UPMC products. Take leadership role in the enhancement, development, documentation, and communication of identified variances.

Responsibilities:

• Meet deadlines and turnaround times set by managers and department director (these deadlines and turnaround times will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both).
• Perform cost/benefit analysis.
• Identify trends in expenses, utilization, medical quality, and other areas.
• Investigate variances and derive solutions to cost increases and quality issues.
• Perform statistical analyses, and then explain this analysis to a non-technical audience of both internal and external customers and, at times, senior management.
• Manage special projects.
• Monitor business unit operating performance against regional, national and international benchmarks.

Qualifications

Bachelor's degree in mathematics, statistics, health care, management, or related business field required. Master's degree preferred. Extensive related experience will be considered. Minimum of two years of related work experience in financial and/or medical analysis required. Experience in health care insurance or health care industry preferred.Strong computer skills, with expert knowledge in Access, Excel, Crystal Reports, Cognos Reports, and other financial & statistical software packages. Ability to work in a fast-paced environment a must. Ability to manage multiple tasks and projects, and forge strong interpersonal relationships within the department, with other departments, and with external audiences. Attention to detail is critical to the success of this position.Excellent planning, communication, documentation, organizational, analytical, and problem solving abilities. Advanced mathematical skills. Ability to interpret and summarize results of various analyses in a timely and meaningful way. Ability to effectively approach problem solving. Ability to re-engineer processes to positively impact productivity in terms of timeliness and accuracy. Ability to analyze financial & clinical results and to comprehend forecasting models. Knowledge and good understanding of all products and benefit designs of UPMC Health.

Preferred:

• Advanced Excel skills
• Excellent Written and Verbal Communications skills
• Experience with policy or compliance.